种植窗期血清孕激素水平及子宫内膜整合素α_vβ_3表达对IVF-ET结局的预测价值

Forecasting Value of Serum Progesterone Level and Endometrial Integrinα_vβ_3 in the Window of Implantation on Pregnancy Result of in vitro Fertilization and Embryo Transfer

目的：探讨种植窗期血清雌(E_2)、孕激素(P)水平及子宫内膜整合素α_vβ_3表达与IVF-ET结局的关系。方法：对40例拟行IVF-ET妇女在IVF-ET前1周期采用磁分离酶联免疫法测定种植窗期血清E_2、P水平；采用免疫组化SP法和组织学积分H-score法对整合素α_vβ_3在种植窗期子宫内膜中的表达进行定位和半定量分析。按IVF-ET后是否妊娠将40例不孕患者分为2组：妊娠组和未妊娠组。结果：种植窗期血清P和整合素α_vβ_3水平妊娠组较未妊娠组高,差异有统计学意义(P：17．80±6．08 ng/ml vs 14．12±4．74 ng/ml,P＜0．05。整合素α_vβ_3：腺体1．73±0．18 vs 1．50±0．23,P＜0．01；腔上皮1．53±0．28 vs 1．12±0．24,P＜0．01)。结论：种植窗期血清P水平下降及子宫内膜整合素α_vβ_3的表达减弱,可导致IVF-ET妊娠失败。种植窗期血清P水平和子宫内膜整合素α_vβ_3的表达可作为预测妊娠是否成功的指标。

Objective： To study the relationship of serum estradiol and progesterone level and the expression of endometrial integrin αvβ3 in the window of implantation and pregnancy result of IVF-ET. Methods： The endometrium tissue samples and serum samples were obtained from 40 patients undergoing IVF-ET in the window of implantation. The levels of the serum E2 and P were measured by magneto-separate homogeneous enzyme immunoassay. The endometrial integrin αvβ3 was detected by immunohistochemistry using polyclonal antibody and semi-quantified by using the H-score. A total of 40 patients were divided into two groups： the pregnancy group （n=16） and non-pregnancy group （n=24）. Results： The serum P level during the window of implantation was significantly higher in pregnancy group than in non-pregnancy one （17.80±6.08 ng/ml vs 14.12±4.74 ng/ml, P〈0.05）. The luminal epithelial and glandular immunostaining integrin αvβ3 scores were significantly higher in pregnancy group than in non-pregnancy one （1.53± 0.28 vs1.12± 0.24, P〈0.05; 1.73±0.18 vs1.50 ±0.23, P〈0.05）, respectively. The correlative analysis ofintegrin αvβ3 in endometrial luminal epithelial and glandular epithelial imunostaing with serum P level showed statistical correlation in two groups （glandular epithelial r=0.678, P〈0.01; luminal epithelial r=0.711, P〈0.01）. Conclusion： The decreased serum P level and the low expressions of endometrial integrin αvβ3 in the window of implantation can result in IVF-ET failure. The serum P level and the expressions of endometrial integrin αvβ3 in the window of implantation can be used to predict IVF-ET result.